Communication Essential Skills for Health Care Professionals

 Students will:  Demonstrate the use of positive communication techniques.  Utilize two types of communication.  Explore possible barriers to communication  Relate and communicate multicultural and multilingual needs.  Differentiate between subjective and objective information.  Maintain confidentiality.  Evaluate technological threats to confidentiality.  Discuss patient/client confidentiality.  Analyze legal ethical aspects of confidentiality. Objectives

 The exchange of information  Two types:  Verbal - written or spoken language  Nonverbal - message spread through body language, gestures, expression Communication

For communication to be effective:  Use words that mean the same thing to you and the receiver of the message.  Use familiar words.  Be brief and concise.  Give information in a logical and orderly manner.  Give facts and be specific Effective Communication

 Sender - person sending the message  Message - information to be conveyed  Receiver - person the information is intended for  Problems in either component can lead to miscommunication and/or misunderstandings Components of Communication

 Communication barrier – Anything that gets in the way of clear communication.  May be in sender, message, or receiver  Common Barriers include:  Psychological attitudes and prejudice  Cultural diversity  Physical disabilities Barriers to Communication

 Barriers to transmitting the message  Terms patient unable to understand  Incorrect grammar & punctuation  Meaningless terms- dog  Phrasing & emphasis of words  Tone & pitch of voice  Speed of speaking  Use of slang or w/ more than one meaning Barriers to Communication

 Background noise or interruptions  Ability to read  Medications  Age  Level of education  Limited English  Visual, hearing, hearing impairment  Attitudes & prejudices  Trust in sender Barriers to receiving the message

 A shared understanding of a message – 7% of a message is conveyed by words – 38% by the tone of voice – 55% by nonverbal behavior  Body language, facial expressions & inappropriate responses may suggest lack of understanding  Rephrasing message will clarify for receiver  Receivers’ attitude & prejudices may interfere  Utilize active listening: reflective statements & clarification  Maintain eye contact, open mind Understanding the message

Answer in complete sentences and give details!  What problems did you encounter?  Why is it so hard to give verbal directions only? Tie Your Shoes Activity

 Psychological barriers are often caused by:  Prejudice  Attitudes  Personality  Stereotypes such as “dumb blonde” or “fat slob” cause us to make snap judgments about others that affect the communication process.  Health care workers must learn to put prejudice aside and show respect for all individuals. Psychological Barriers

 Health care workers must examine any prejudices they may have and learn to put these aside  Never use language that others may view as offensive  Learning to “read” others body language can help to prevent misunderstanding Guidelines

 All cultural beliefs must be respected.  Every culture has beliefs and practices regarding health and illness such as:  the body needs balance – if the body is cold, they eat hot foods.  illness is due to demons and evil spirits  illness is punishment from God  Patients may practice their cultural remedies in addition to modern healthcare techniques. Cultural Barriers

 Language differences – people who don’t speak English may have a difficult time communicating. You should:  Speak slowly  Use nonverbal communication (smile)  Avoid tendency to speak louder  Find an interpreter Guidelines for Cultural Diversity

 Eye contact – in some cultures, it’s not acceptable, and looking down is a sign of respect  Terminal illness – in some cultures, the patient is NOT told his/her prognosis, and family members are responsible for making care decisions  Touch – in some cultures, it is wrong to touch someone on the head. Others may limit touch between male and female  Personal care – in some cultures, only family members provide personal care Guidelines for Cultural Differences

 Respect and acceptance of cultural diversity is essential for any health care worker.  If unsure of cultural practices, speak with the patient or family to prevent future misunderstandings Guidelines for Cultural Differences

Physical barriers may include:  Deafness or hearing loss  Blindness or impaired vision  Aphasia or speech disabilities Physical Barriers

 Use body language such as gestures and signs.  Speak clearly in short sentences.  Face the individual to facilitate lip reading.  Write messages if necessary.  Make sure hearing aids are working properly Communicating with the Hearing Impaired

 Use a soft tone of voice.  Describe events that are occurring.  Announce your presence as you enter a room.  Explain sounds or noises.  Use touch when appropriate. Communicating with the Visually Impaired

These patients may have difficulty remembering the correct words, may not be able to pronounce certain words, and may have slurred speech.  The health care worker must be patient  Allow them to try and speak  Encourage them to take their time  Repeat the message to assure accuracy  Encourage them to use gestures or point to objects  Provide pen and paper if they can write  Use pictures with key messages communicate Communicating with Patients with Aphasia or Speech Impediments

 Cell phone usage is increasing dramatically  a. Cell phone usage has been soaring for the past 15 years  i. 1991: 7.6 million cell phone subscribers in the US  ii. 2001: 120 million cell phone subscribers in the US  iii. 2009: 308 million cell phone subscribers in US  b. 89% of the US population uses cell phones Mobile Manners

 Buisness  Emergencies  Answering machines  Internet link  Music  Camera  social Uses

 3% of drivers are talking on hand-held cell phones at any given time  Drivers using phones are four times as likely to get into crashes serious enough to cause injury.  Studies are being done to determine potential health hazards associated with the use of cell phones. Hazards

 Accidents nonrelated to driving  Watch where you are going. Tripping and falling Walking into objects or other people Stay alert. Not paying attention to your surroundings can put you at risk of being mugged Hazards

 a. New technologies are often first adopted by younger segments of  a society.  b. Rapid adoption of cell phone usage by all generations is  reshaping the entire communication landscape. c. Connected 24/7/365  d. Has extended the work day  e. Cell phone “jammers” have been developed due to new cell phone technology. Technological change leads to social change

 a. A set of rules we all agree to follow in order to be considerate  toward others  b. It is a question of awareness of how your actions affect others.  c. Simple guidelines of common courtesy  d. Contribute to a more polite society  e. Just a matter of being considerate of others  f. With so many cell phone users, it is necessary to have a few guidelines regarding cell phone use. Etiquette

 Modulate your voice.  i. Use your “inside voice”: a quiet conversational tone.  ii. There is no need to shout into or at a phone.  iii. Cell phones have sensitive microphones that can pick up a  very soft voice while blocking out ambient noise. The Simple Rules

 i. Maintain a distance of at least 10 feet from the nearest  person when taking on a cell phone.  ii. Don’t force others to overhear your personal business.  Bystanders can hear the steady streams of  shocking and confidential revelations that are  blurted out by cell phone users.  Private issues should be kept private.  Forcing others to hear your phone conversations is  an intrusion on their thoughts.  Imposes, infringes, intrudes  iii. Keep your conversation private. 10-foot Proximity Rule

 Avoid taking calls when you’re already engaged in a face- toface  conversation.   Gives the impression that you do not value the  person in front of you  ii. It is inconsiderate to take a call in the middle of a  conversation.  iii. Never take a personal call during a business meeting. Love the One You’re With.

 This includes interviews and meetings with coworkers  or subordinates  If you must take a call, ask permission of the people with  you.  The same principle applies when you are ordering food.  Give the waiter your attention.  Don’t just point to a menu item and shake your  head.  The same set of rules for texting during face-to-face  conversations – it is rude  Ear plugs  Many are near invisible  People cannot tell if you are talking to them,  someone on the cell, or your invisible friend

 Put your phone’s ringer on “silent” in theaters, courtrooms, places of worship, and restaurants.  Don’t light up your phone’s screen in a dark theater.  If you forget to turn your phone off or set it to silent, don’t answer it if it rings – turn it off immediately.  You can leave the room and return the call.  Just let the caller leave you a message, and get back to them later.  iv. No Talking Zones  Elevators, libraries, museums, restaurants, cemeteries, theaters, medical offices, and enclosed public spaces Lights Out, Phones Off

 Multitasking isn’t always a good thing.  Most calls can wait until you’ve reached your destination.  if the call is upsetting, it will affect your ability to drive safely. Hang up and drive.

 Reporting is the oral account of care and observations.  Recording (charting) is the written account of care and observations.  During end-of-shift report, information is shared about:  The care given  The care that must be given  The person’s condition Recording and Reporting

 Communication between health care workers is critical in ensuring quality patient care.  Workers must listen carefully and make observations.  Observations must be accurate, concise, and complete.  Use facts and report only what you saw, not the reasons.  NOT – “Mrs. Jones is in pain.”  INSTEAD – “Mrs. Jones is holding her chest with wheezing as she breathes.”  Objective / Sign – what was seen or Observed  Subjective / Symptom - what the patient Said Recording and Reporting

 Health care workers use their senses to: See  Color of skin, swelling or edema  Presence of rash or sore  Color of urine or stool  Amount of food eaten Smell  Body odor  Unusual odors of breath, wounds, urine or stool (feces) Observations

Touch  Pulse  Dryness or temperature of skin  Perspiration  Swelling Hearing  Respirations  Abnormal body sounds  Coughs  Speech Observations

The medical record, or chart, is:  A written account of a person’s condition and response to treatment and care  A permanent, legal document Medical facilities have policies about:  Who can see them  Who records  When to record  Abbreviations  How to correcting errors  What color of ink to use  How to sign entries The Medical Record

You have an ethical and legal duty to keep the person’s information confidential. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides federal protections for personal health information and gives patients an array of rights with respect to that information. Confidentiality

 Health care workers have access to information related to the care of their patients.  Any information is confidential and is only reported to others involved in care of the patient.  Care must be taken when reporting any information to prevent others from hearing the information.  Patient information should never be discussed in public areas such as hallways, cafeterias, elevators, etc. HIPAA Guidelines

Recording Time  Many facilities use a 24 hour clock.  It eases the confusion of whether a time is AM or PM.  1:00am  1:00pm  6:30am  6:30pm

 Computers are routinely used in health care facilities to collect, send, record, and store information.  The following guidelines apply:  Use computers only for work purposes.  Do not share your password.  Employers may monitor your computer use. Computers in Health Care

 Good communication skills are needed when answering phones.  Be professional and courteous.  Answer with a greeting, your location, name, and title.  Take messages accurately and deliver promptly.  Follow the center’s policies regarding who can answer and take messages.  Many facilities restrict cell phone use during work hours. Phone communications

 Conflict can occur in any setting.  If problems are not worked out, the following can occur:  Unkind words or actions occur.  The work setting becomes unpleasant.  Care is affected. Conflict

 Ask your supervisor for some time to talk privately.  Approach the person with whom you have the conflict.  Agree on a time and place to talk.  Talk in a private setting.  Explain the problem.  Listen to the person.  Identify ways to solve the problem.  Set a date and time to review the matter.  Thank the person for meeting with you.  Carry out the solution.  Review the matter as scheduled. Dealing with Conflict

Use the following steps to help resolve conflict. 1.Define the problem. 2.Collect information. 1.The information must be about the problem. 3.Identify possible solutions. 4.Select the best solution. 5.Carry out the solution. 6.Evaluate the results Problem - Solving